Harnessing memory adaptive regulatory T cells to control autoimmunity in type 1 diabetes

Type 1 diabetes(T1D)results from autoimmune destruction of insulin-producing b-cells in the pancreatic islets.There is an immediate need to restore both b-cell function and immune tolerance to control disease progression and ultimately cure T1D.Currently,there is no effective treatment strategy to restore glucose regulation in patients with T1D.FoxP3-expressing CD4^(+) regulatory T cells(Tregs)are potential candidates to control autoimmunity because they play a central role in maintaining self-tolerance.However,deficiencies in either naturally occurring Tregs(nTregs)themselves and/or their ability to control pathogenic effector T cells have been associated with T1D.Here,we hypothesize that nTregs can be replaced by FoxP3^(+) adaptive Tregs(aTregs),which are uniquely equipped to combat autoreactivity in T1D.Unlike nTregs,aTregs are stable and provide long-lived protection.In this review,we summarize the current understanding of aTregs and their potential for use as an immunological intervention to treat T1D.